Putting Patient Records Online: Do the Incentives Account for the Risks?

In The New York Times today, Steve Lohr wrote an article about how the drive towards making patient records available online has taken a huge step forward by a major New York regional hospital group, North Shore-Long Island Jewish Health System. The group plans on offering its affiliated doctors subsidies of up to $40,000 each over five years to adopt digital patient records. This would be in addition to the federal government subsidies for computerizing patient records, which could total $44,000. The hospitals see this as a two-fold proposition: (1) it allows to share data amongst offices, labs, and hospitals that reduce unnecessary tests and cut down on medical mistakes; and (2) it’s a way for the hospitals to strengthen their bonds with their doctors, due to the fact that some independent doctors affiliate with more than one organization.

According to Mr. Lohr, the government-backed campaign to hasten the adoption of electronic health records has the potential not only to change how health care is delivered. It could also influence which institutions emerge as leaders in delivering care, as some local markets consolidate further. “We are going to change how we deliver care, and we should be held accountable for outcomes — not just measured on the number of procedures performed,” Mr. Dowling said. Indeed, the rationale for investing in digital records is that the technology can be used to help monitor and measure the results of care, providing the evidence needed to shift remuneration away from the current fee-for-service system, which encourages more tests, more procedures and more pills prescribed.

With all this talk about "incentives", healthcare providers need to ensure its patients that their personal healthcare information is accessible only to parties with privity. Having a comprehensive data governance program implemented throughout the organization is the only way for these providers to be assured that the confidentiality, integrity, and accessibility of those records are preserved.. Who is getting accessibility to private medical data, and whether the medium used is adequate to ensure confidentiality, will be determinative of who is held "accountable for outcomes."